The ideal study should be conducted with a similar design, but adding a control group to account for changes induced by natural growth. The reproducibility of facial expressions before and after TBA treatment could also be assessed by taking 3D images at two time points, 10-15 minutes apart, before and after TBA treatment.
108
Future studies can also use different types of functional appliances or have more than one treatment groups to compare and contrast the effects of different FAs on soft tissue changes.
A 3D comparison of TBA treatment outcome using different types of bite registration techniques could also be conducted such as; project bite versus traditional use of thick wax wafer or single advancement technique versus incremental advancement.
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CHAPTER SEVEN
CONCLUSIONS
110
7. Conclusions
The aims and null hypotheses of this thesis were given in Chapter 3. The conclusions together with the impact of the results on the null hypotheses are given below.
Aim 1: To identify 3D soft tissue volumetric and linear landmark changes following
treatment with the TBA
Conclusions
• TBA treatment, in growing subjects, increased the lower facial soft tissue volume and this increase was slightly more for males.
• TBA treatment, in growing patients, caused forward movement of the lower soft tissue facial profile landmarks (labiale inferius, sublabiale and pogonion) and this was similar for females and males.
Null hypothesis 1: The TBA treatment has no effect on the 3D soft tissue volumetric
and linear landmark changes.
The null hypothesis is rejected.
Aim 2: To estimate the TBA treatment outcome on the soft tissue volumetric and linear
landmark changes from the Postured Wax Bite (PWB).
Conclusions:
• The estimated mean volumetric change in the soft tissues following a TBA treatment was 60% of the mean volumetric change produced by the PWB (for females ~ 40% and for males ~ 70%).
111
• The estimated change, for the lower facial profile (the chin and the lower lip), following a TBA treatment was 4 mm behind the change produced by the PWB (similar for females and males).
• The PWB is an easy, cheap and non-invasive tool that can be used to estimate TBA treatment outcome on the soft tissues.
Null hypothesis 2: The PWB has no effect on the soft tissue volumetric and linear
landmark changes and it cannot be used to estimate the TBA treatment outcome on the soft tissue profile.
The null hypothesis is rejected.
Aim 3: To identify if there is any association between certain soft tissue landmark
variables and successful treatment outcome of the TBA as measured by the reduction in overjet.
Conclusion:
• No association was found between any soft tissue landmark variable and successful overjet reduction after treatment with the TBA.
Null hypothesis 3: There is no association between any soft tissue landmark variable
and successful overjet reduction following treatment with the TBA
The null hypothesis is accepted
Aim 4: To assess the effects of TBA treatment on facial expressions at rest, natural
smile and maximal smile.
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• TBA treatment had no effect on the upper facial landmarks for each facial expression.
• TBA treatment changed the facial expressions for the lower landmarks except for maximum smile in males.
Null hypothesis 4: Treatment with the TBA has no effect on the facial expressions
at rest, natural smile and maximal smile
The null hypothesis is accepted for the upper landmarks and rejected for the lower landmarks except for maximum smile in males.
113
CHAPTER EIGHT
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114
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